Specially designed stents for translumenal drainage
Publication date: Available online 26 March 2015 Source:Gastrointestinal Intervention Author(s): Frank Weilert , Kenneth F. Binmoeller EUS-guided translumenal drainage of pancreatic fluid collections and obstructed bile and pancreatic ducts has been widely practiced for over a decade now using conventional tubular plastic and metal stents. Their application for transmural drainage has been "off label" and limited by the lack of lumen-to-lumen anchorage that can lead to leakage, perforation, and stent migration. In addition, the length of a tubular stent exceeding the anatomical requirement of a translumenal anastomos...
Source: Gastrointestinal Intervention - April 3, 2015 Category: Gastroenterology Source Type: research
Management of Malignant Distal Biliary Obstruction
Publication date: Available online 11 February 2015 Source:Gastrointestinal Intervention Author(s): Lisa Cassani , Jeffrey H. Lee The most common cause of malignant distal biliary obstruction is pancreatic cancer, as 70% to 90% of patients will develop jaundice during the course of their disease. Pancreatic cancer is usually advanced at presentation, and curative resection is possible in less than 15% of patients. If a patient is to undergo early surgical resection, biliary drainage is not prerequisite. Early surgery without preoperative biliary drainage did not increase the risk of complications, as compared with pr...
Source: Gastrointestinal Intervention - February 12, 2015 Category: Gastroenterology Source Type: research
Radiological Approach to Benign Biliary Strictures
Publication date: Available online 31 January 2015 Source:Gastrointestinal Intervention Author(s): Dong II. Gwon , Hans-Ulrich Laasch Benign biliary strictures can be due to a large variety of causes, but are commonly iatrogenic after direct or vascular injury during laparoscopic cholecystectomy and other biliary procedures. An increasing number of patients present with strictures of bilio-enteric anastomoses after liver transplantation and radical surgery for hepato-pancreatico-biliary (HPB) cancer. Endoscopic access to the biliary tree may be difficult or impossible following pancreatico-duodenectomy and in this co...
Source: Gastrointestinal Intervention - January 31, 2015 Category: Gastroenterology Source Type: research
Stent Placement in Benign Esophageal Strictures
Publication date: Available online 26 December 2014 Source:Gastrointestinal Intervention Author(s): Wei-Zhong Zhou , Ho-Young Song , Jung-Hoon Park , Ji Hoon Shin , Jin Hyoung Kim For benign esophageal strictures, the primary treatment is balloon dilation. However, approximately 10% of the strictures are not improved after balloon dilation and are defined as refractory benign esophageal strictures. The main causes of refractory benign esophageal strictures are esophageal surgery, caustic injury, and radiotherapy. Self-expandable stents, used primarily for the palliation of malignant esophageal strictures, are now ...
Source: Gastrointestinal Intervention - December 27, 2014 Category: Gastroenterology Source Type: research
A re-review of caspule endoscopies of patients referred for deep enteroscopy changes their management
Conclusion A review of referral VCE studies led to a change in management in a large percentage of patients, particularly when the indication was polyp, mass, or ulcer. Patients referred for deep enteroscopy should have their capsule re-read by an enteroscopist prior to scheduling the procedure. (Source: Gastrointestinal Intervention)
Source: Gastrointestinal Intervention - December 23, 2014 Category: Gastroenterology Source Type: research
Small bowel intervention and application of enteroscopy for altered small bowel anatomy—endoscopic advanced therapy using double balloon enteroscopy
Publication date: Available online 18 October 2014 Source:Gastrointestinal Intervention Author(s): Masaaki Shimatani , Norimasa Fukata , Ryo Suzuki , Sachi Miyamoto , Kota Kato , Toshiyuki Mitsuyama , Hideaki Miyoshi , Tsukasa Ikeura , Makoto Takaoka , Kazuichi Okazaki The management of patients with small bowel obstruction distal to the third part of the duodenum and altered gastrointestinal anatomy is challenging. Until recently, surgery had been the mainstay of treatment for obstruction, which had however posed a risk of serious complications. The difficulty with the endoscopic approach in the deep area of...
Source: Gastrointestinal Intervention - November 22, 2014 Category: Gastroenterology Source Type: research
Looking beyond lymph nodes: Beware of the lurking pseudoaneurysm!
We describe a case of a superior mesenteric artery–superior mesenteric vein (SMA/SMV) pseudoaneurysm that was initially misinterpreted as an enlarging hypervascular nodal metastasis on surveillance computed tomography (CT) in a patient who had undergone ileal carcinoid resection. When the case was discussed at the specialist multidisciplinary meeting to consider surgical resection, it was noted that the apparent “hypervascular node” on CT had a signal void character on magnetic resonance imaging, which is atypical for a lymph node. Coronal CT reformat demonstrated a vascular origin from the superior mesenteric trunk....
Source: Gastrointestinal Intervention - November 20, 2014 Category: Gastroenterology Source Type: research
What is the best method for endoscopic ultrasound-guided fine needle aspiration? Needle types and aspiration techniques
Conclusion The score for the reverse-beveled needle was better than that of the soft-type needle. The slow-pull technique may be useful for a bloody tumor, but it provides less specimen. We should select the EUS-FNA method based on the relevant patient and tumor characteristics. (Source: Gastrointestinal Intervention)
Source: Gastrointestinal Intervention - November 8, 2014 Category: Gastroenterology Source Type: research
Acute cholecystitis at ER—We can remove it!
Publication date: June 2013 Source:Gastrointestinal Intervention, Volume 2, Issue 1 Author(s): Keon-Young Lee The optimal management of patients suffering from acute cholecystitis presenting in the emergency room is cholecystectomy, preferably laparoscopic. However, the operation mandates a general anesthesia, and some patients are considered to be at high risk for the procedure. However, cholecystectomy is not without complications, among which inadvertent bile duct injury is the most serious, because it can be a cause of mortality. Alternatively, the patient can be managed conservatively with or without drainage pro...
Source: Gastrointestinal Intervention - November 1, 2014 Category: Gastroenterology Source Type: research
Acute cholecystitis: We can drain it!
Publication date: June 2013 Source:Gastrointestinal Intervention, Volume 2, Issue 1 Author(s): Hyun-Ki Yoon Laparoscopic cholecystectomy has recently been accepted as the standard treatment for acute cholecystitis patients. The major role of percutaneous transhepatic gallbladder drainage has been temporarily stabilizing the patient's acute debilitating condition prior to cholecystectomy. However, there have not been any evidence-based treatment guidelines for acute cholecystitis patients. In this article, the author restates the role of percutaneous transhepatic gallbladder drainage in patients with acute cholecystiti...
Source: Gastrointestinal Intervention - November 1, 2014 Category: Gastroenterology Source Type: research
Diagnosis and management of acute pancreatitis and its complications
This article reviews historical and current concepts in the diagnosis and management of acute pancreatitis and its complications, including radiological diagnosis and percutaneous intervention, as well as endoscopic and surgical management. (Source: Gastrointestinal Intervention)
Source: Gastrointestinal Intervention - November 1, 2014 Category: Gastroenterology Source Type: research
Can endoscopic ultrasound help to drain the gallbladder?
This article is a detailed review of the use of EUS for gallbladder drainage, with an emphasis on its technical aspects. (Source: Gastrointestinal Intervention)
Source: Gastrointestinal Intervention - November 1, 2014 Category: Gastroenterology Source Type: research
Self-expandable metal stents for endoscopic ultrasound-guided drainage of peripancreatic fluid collections
Publication date: June 2013 Source:Gastrointestinal Intervention, Volume 2, Issue 1 Author(s): Daisy Walter , Frank P. Vleggaar , Peter D. Siersema Endoscopic ultrasound (EUS)-guided transmural drainage has evolved as an important treatment modality for peripancreatic fluid collections (PFCs). Recently, self-expandable metal stents (SEMS) have been introduced as an alternative for the traditionally used double-pigtail plastic stents, for endoscopic drainage. Due to the larger diameter (>10 mm) of SEMS, a wide drainage opening can be created, with a potentially reduced risk of stent occlusion and associated c...
Source: Gastrointestinal Intervention - November 1, 2014 Category: Gastroenterology Source Type: research
EUS-guided interventional management of pancreatic tumor
Publication date: June 2013 Source:Gastrointestinal Intervention, Volume 2, Issue 1 Author(s): Pazhanivel Mohan , Dong Wan Seo Pancreatic cancer is one of the most common causes of cancer-related death worldwide. Most patients have advanced disease at diagnosis, resulting in a very poor prognosis. Hence there is a need for newer therapeutic strategies and novel approaches to the management of these tumors. Advances in endoscopic ultrasound have brought a change in its role from being solely a diagnostic tool to having a therapeutic role in gastrointestinal malignancies. Interventional endoscopic ultrasound is useful ...
Source: Gastrointestinal Intervention - November 1, 2014 Category: Gastroenterology Source Type: research
Role of a forward-viewing echoendoscope in fine-needle aspiration
Publication date: June 2013 Source:Gastrointestinal Intervention, Volume 2, Issue 1 Author(s): Mitsuhiro Kida , Masao Araki , Shuko Tokunaga , Hiroshi Yamauchi , Kousuke Okuwaki , Shiro Miyazawa , Tomohisa Iwai , Miyoko Takezawa , Hidehiko Kikuchi , Maya Watanabe , Hiroshi Imaizumi , Wasaburo Koizumi A prototype forward-viewing echoendoscope has been developed for therapeutic endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The hard tip of the forward-viewing echoendoscope, which is shorter than that of the convex type echoendoscope, can be maneuvered flexibly. Using the forward-viewing echoen...
Source: Gastrointestinal Intervention - November 1, 2014 Category: Gastroenterology Source Type: research
